A surgical access device includes a seal assembly having a seal housing and a gimbal mount disposed within the seal housing, the seal housing defining a central longitudinal axis and having a longitudinal passage for receiving at least one surgical object therethrough and the gimbal mount adapted for angular movement relative to the central longitudinal axis. The surgical access device also includes at least one centering unit configured to engage at least a portion of the gimbal mount. The at least one centering unit is configured to center the longitudinal passage of the seal assembly with the central longitudinal axis.
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11. A cannula assembly, comprising:
a cannula housing;
a cannula sleeve extending distally from the cannula housing; and
a seal assembly disposed in mechanical cooperation with the cannula housing, the seal assembly comprising:
a seal housing and a gimbal mount disposed within the seal housing, the gimbal mount having a sealing aperture, the seal housing defining a central longitudinal axis and having a longitudinal passage for receiving at least one surgical object therethrough and the gimbal mount adapted for angular movement relative to the central longitudinal axis; and
at least one centering unit, a distal portion of the at least one centering unit configured to engage a proximal rim of the gimbal mount, the at least one centering unit defining an axis in a plane parallel to the central longitudinal axis in an unbiased configuration.
1. A surgical access device, comprising:
a seal assembly including a seal housing and a gimbal mount disposed within the seal housing, the seal housing having an upper housing portion and a lower housing portion, and defining a central longitudinal axis and having a longitudinal passage for receiving at least one surgical object therethrough and the gimbal mount adapted for angular movement relative to the central longitudinal axis; and
at least one centering unit having a proximal end and a distal end, the at least one centering unit defining an axis in a plane parallel to the central longitudinal axis in an unbiased position;
wherein the proximal end of the at least one centering unit is connected to the upper housing portion of the seal housing and the distal end of the at least one centering unit is configured to contact a proximal surface of the gimbal mount.
2. The surgical access device according to
3. The surgical access device according to
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9. The surgical access device according to
10. The surgical access device according to
12. The surgical access device according to
13. The cannula assembly according to
14. The cannula assembly according to
17. The cannula assembly according to
18. The cannula assembly according to
19. The cannula assembly according to
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The present application claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/647,004, filed on May 15, 2012, the entire contents of which are incorporated herein by reference.
1. Technical Field
The present disclosure relates to a seal system adapted to permit the introduction of surgical instrumentation into a patient's body. In particular, the present disclosure relates to a seal system for use with an introducer or access device, which is intended for insertion into a patient's body, and to receive an instrument in sealing engagement therewith.
2. Background of Related Art
Minimally invasive and laparoscopic procedures generally require that any instrumentation inserted into the body is sealed, i.e., provisions must be made to ensure that gases and/or fluids do not enter or exit the body through an endoscopic incision, such as, for example in surgical procedures where the surgical region is insufflated. For such procedures, the introduction of a tube into anatomical cavities, such as the peritoneal cavity, is usually accomplished by use of a system incorporating a trocar and cannula assembly. Since the cannula is in direct communication with the interior of the peritoneal cavity, insertion of the cannula into an opening in the patient's body to reach the inner abdominal cavity should be adapted to maintain a fluid tight interface between the abdominal cavity and the outside atmosphere.
In view of the need to maintain the atmospheric integrity of the inner area of the cavity, a seal assembly for a cannula, which permits introduction of a wide range of surgical instrumentation and maintains the atmospheric integrity of the inner area of the cavity, is desirable. In this regard, there have been a number of attempts in the prior art to achieve such sealing requirements. A difficulty encountered with conventional seal assemblies, however, is the inability of accommodating the wide range of sizes of instrumentation. In addition, angulation and/or manipulation of instrumentation within the cannula often present difficulties with respect to maintaining seal integrity.
According to an aspect of the present disclosure, a surgical access device is provided. The surgical access device includes a seal assembly including a seal housing and a gimbal mount disposed within the seal housing, the seal housing defining a central longitudinal axis and having a longitudinal passage for receiving at least one surgical object therethrough and the gimbal mount adapted for angular movement relative to the central longitudinal axis. The surgical access device also includes at least one centering unit configured to engage at least a portion of the gimbal mount. The at least one centering unit is configured to center the longitudinal passage of the seal assembly with the central longitudinal axis. In previous seal arrangements, when a movable valve is in a position in which its longitudinal passage is mis-aligned with the central longitudinal axis, friction that exists between the valve, e.g., a gimbal mount, and the seal housing prevents the longitudinal passage of the valve from aligning with the central longitudinal axis. When this occurs, insertion of instruments through the valve is more likely to tear or otherwise damage the valve, because the sharp tip of such an instrument engages the elastomeric material adjacent to the passage, rather than passing directly through the passage, or else engages the elastomeric material too far from the passage such that the valve is unable to move sufficiently before being torn. By biasing the longitudinal passage of the seal assembly towards the central longitudinal axis, the at least one centering unit overcomes the frictional relationship that exists between the gimbal mount and the seal housing, and thereby may decrease the likelihood that the gimbal mount will be damaged during use.
In one exemplary embodiment, the at least one centering unit is a compression spring. In an alternative embodiment, the at least one centering unit is a sinusoidal spring. In another alternative embodiment, the at least one centering unit is a wave spring. In yet another alternative embodiment, the at least one centering unit is a leaf-type spring.
In another exemplary embodiment, the at least one centering unit is configured to return the gimbal mount to an initial, unbiased position.
The at least one centering unit is dimensioned and adapted to bias the gimbal mount in a proximal direction against an arcuate surface of the seal housing.
In yet another exemplary embodiment, the seal housing is disposed in mechanical cooperation with a cannula assembly. Moreover, the cannula assembly may detachably connect to the gimbal mount via a plurality of sealing points.
According to another aspect of the present disclosure, a cannula assembly is provided. The cannula assembly includes a cannula housing, a cannula sleeve extending distally from the cannula housing and a seal assembly disposed in mechanical cooperation with the cannula housing. The seal assembly includes a seal housing and a gimbal mount disposed within the seal housing, the seal housing defining a central longitudinal axis and having a longitudinal passage for receiving at least one surgical object therethrough and the gimbal mount adapted for angular movement relative to the central longitudinal axis. The seal housing also includes at least one centering unit configured to engage at least a portion of the gimbal mount, the at least one centering unit dimensioned and adapted to overcome a frictional relationship that exists between the gimbal mount and the seal housing so as to center the longitudinal passage of the seal assembly with the central longitudinal axis.
Further scope of applicability of the present disclosure will become apparent from the detailed description given hereinafter. However, it should be understood that the detailed description and specific examples, while indicating preferred embodiments of the present disclosure, are given by way of illustration only, since various changes and modifications within the spirit and scope of the present disclosure will become apparent to those skilled in the art from this detailed description.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the disclosure and, together with a general description of the disclosure given above, and the detailed description of the embodiment(s) given below, serve to explain the principles of the disclosure, wherein:
The figures depict preferred embodiments of the present disclosure for purposes of illustration only. One skilled in the art will readily recognize from the following discussion that alternative embodiments of the structures and methods illustrated herein may be employed without departing from the principles of the present disclosure described herein.
Particular embodiments of the present disclosure are described hereinbelow with reference to the accompanying drawings. However, it is to be understood that the disclosed embodiments are merely exemplary of the disclosure and may be embodied in various forms. Well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present disclosure in virtually any appropriately detailed structure.
For the purposes of promoting an understanding of the principles of the present disclosure, reference will now be made to the exemplary embodiments illustrated in the drawings, and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the present disclosure is thereby intended. Any alterations and further modifications of the inventive features illustrated herein, and any additional applications of the principles of the present disclosure as illustrated herein, which would occur to one skilled in the relevant art and having possession of this disclosure, are to be considered within the scope of the present disclosure.
The seal assembly of the present disclosure, either alone or in combination with a seal system internal to a cannula assembly, provides a substantial seal between a body cavity of a patient and the outside atmosphere before, during and after insertion of an instrument through the cannula assembly. Moreover, the seal assembly of the present disclosure is capable of accommodating instruments of varying diameters, e.g., from 5 mm to 15 mm, by providing a gas tight seal with each instrument when inserted. The flexibility of the present seal assembly greatly facilitates endoscopic surgery where a variety of instruments having differing diameters are often needed during a single surgical procedure.
The seal assembly contemplates the introduction and manipulation of various types of instrumentation adapted for insertion through a trocar and/or cannula assembly while maintaining a fluid tight interface about the instrumentation to preserve the atmospheric integrity of a surgical procedure from gas and/or fluid leakage. Specifically, the seal assembly accommodates angular manipulation of the surgical instrument relative to the seal housing axis. This feature of the present disclosure desirably minimizes the entry and exit of gases and/or fluids to/from the body cavity. Examples of instrumentation include clip appliers, graspers, dissectors, retractors, staplers, laser probes, photographic devices, endoscopes and laparoscopes, tubes, and the like. Such instruments will be collectively referred to herein as “instruments or instrumentation.”
Embodiments of the presently disclosed apparatus will now be described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein, the term “distal” refers to that portion of the tool, or component thereof which is further from the user while the term “proximal” refers to that portion of the tool or component thereof which is closer to the user.
Reference will now be made in detail to embodiments of the present disclosure. While certain embodiments of the present disclosure will be described, it will be understood that it is not intended to limit the embodiments of the present disclosure to those described embodiments. To the contrary, reference to embodiments of the present disclosure is intended to cover alternatives, modifications, and equivalents as may be included within the spirit and scope of the embodiments of the present disclosure as defined by the appended claims.
Referring now to the drawings, in which like reference numerals identify identical or substantially similar parts throughout the several views,
Cannula assembly 200 includes cannula sleeve 202 and cannula housing 204 mounted to an end of the sleeve 202. Cannula sleeve 202 defines a longitudinal axis “a” extending along the length of sleeve 202. Sleeve 202 further defines an internal longitudinal passage dimensioned to permit passage of surgical instrumentation. Sleeve 202 may be formed of stainless steel or other rigid materials, such as a polymeric material or the like. Sleeve 202 may be clear or opaque. The diameter of sleeve 202 may vary, but typically ranges from 10 to 15 mm for use with the seal assembly 100 of the present disclosure.
Cannula housing 204 includes two components, specifically, housing flange 206, which is attached to the proximal end of cannula sleeve 202 and main housing 208, as shown in
With reference to
Referring again to
Seal housing 102 incorporates three housing components, namely, proximal, distal and inner housing components 106, 108, 110, respectively, which, when assembled together, form the seal housing 102. The proximal inner housing component 106 may also be referred to as the “upper housing portion,” whereas the distal inner housing components 108, 110 may also be referred to as “lower housing portions.” Assembly of housing components 106, 108, 110 may be affected by any of the aforementioned connection means discussed with respect to cannula housing 204. Therefore, seal housing 102 may be considered as having an upper housing portion formed by component 106 and a detachable inner housing portion formed by components 108, 110.
Proximal housing component 106 defines inner guide wall 112 and outer wall 114 disposed radially outwardly of the inner guide wall 112. Inner guide wall 112 defines central passage 116, which is dimensioned to receive a surgical instrument and laterally confine the instrument within seal housing 102. Inner guide wall 112 is generally cylindrical in configuration and terminates in a distal arcuate surface 118. Outer wall 114 defines an annular recess 120 adjacent its distal end. Recess 120 receives annular lip 124 (see
Housing component 110 is disposed within the interior of distal housing component 108 and is securely connectable to the distal housing component 108 through a bayonet coupling. Such coupling includes radially spaced tongues 128, which depend radially inwardly to be received within correspondingly arranged grooves or recesses 130 on the exterior of inner housing component 110. Coupling of distal and inner housing components 108, 110 is thereby affected through simple rotation of the components.
Housing component 108 includes transverse wall 122 (see
With continued reference to
Referring to
Gimbal mount 104 is accommodated within an annular space 134 defined between inner and outer walls 112, 114 of proximal housing component 106 (see
With further reference to
Seal member 142 of gimbal mount 104 is secured in interposed relation between first and second gimbal housings 138, 140. Seal member 142 preferably comprises a resilient center material (e.g., polyisoprene or natural rubber) with first and second layers of fabric 151, 152 impregnated on the respective proximal and distal surfaces of the resilient center material. Fabric may be of any suitable fabric for example, a SPANDEX material containing about 20% LYCRA and about 80% NYLON available from Milliken.
Seal member 142 defines central aperture 154 for sealed reception of a surgical instrument. In a preferred arrangement, first layer 151 is arranged to extend or overlap into aperture 154. In this manner, the fabric (which is stronger relative to the resilient material) is positioned to engage the surgical instrument upon passage through aperture 154 of seal member 142 thereby protecting the resilient material defining the aperture 154. This advantageously minimizes the potential of piercing, penetrating or tearing of the resilient material by the instrument. Furthermore, seal member 142 includes an annular depression 156 on its distal surface, i.e., within second layer 152 of fabric. Depression 156 receives ledge 158 of second gimbal housing 140 to facilitate fixation of seal member 142 between first and second gimbal housings 138, 140.
Gimbal mount 104 is free to move within the annular space 134 defined between inner and outer walls 112, 114 and in cooperation with centering units 410 to permit angulation of the instrument relative to the seal axis “b,” while still maintaining a seal thereabout. Specifically, gimbal mount 104 is adapted for swiveling movement about a center of rotation “c,” which is coincident with the axis “a” of seal assembly 100. In this regard, the axis “c” of the aperture 154 of seal member 142 intersects the axis “a” of the seal assembly 100 during angulation of the instrument, “i.” During angulation, gimbal mount 104 is only in contact with seal housing 102 along distal arcuate surface 118 of proximal housing 106. Specifically, the arcuate inner surface of first gimbal housing 138 rides along distal arcuate surface 118 of inner wall 112 in contacting relation therewith to permit gimbal mount 104 to swivel within seal housing 102. A lubricant may be provided between distal arcuate surface 118 and the inner surface of first gimbal housing 138 to facilitate angulation. In a preferred arrangement, gimbal mount 104 may angulate through an angle inclusive of about 30°, more preferably about 22.5° relative to seal housing axes “a” and “b.”
Referring to
As shown, gimbal mount 104 has been biased in a direction “d.” For example, a surgical instrument “i” (see
Referring to
Seal assembly 100 may be associated with, or joined to, cannula assembly 200 in a variety of ways. In a preferred embodiment, seal housing 102 of seal assembly 100 and cannula housing 204 of cannula assembly 200 are adapted to detachably engage each other, e.g., through a bayonet lock or like mechanical means. As previously discussed, proximal and distal housing components 106, 108 may define an upper housing component 505, which is mountable directly to cannula assembly 200. The upper housing component 505 may be separated from the lower housing component 507. The upper housing component 505 may include one or more first projection members 510. The lower housing member 507 may include one or more second projection members 520. The one or more first projection members 510 cooperate or frictionally engage with the one or more second projection members 520 in order to connect the upper housing component 505 to the lower housing component 507. As such, a user may interchange the upper housing component 505 with any other upper housing portion having a variety of different centering units based on the surgical procedure to be performed. Additionally, the user may interchange the lower housing component 507 with any other lower housing portion including any type of seal therein (e.g., a duck bill seal). Therefore, the attachability/detachability of the upper and lower housing components 505, 507 enable system flexibility by allowing the user to select different seal and/or centering unit combinations for a variety of different surgical procedures.
For example,
Referring now to
Similarly, second gimbal housing 140 includes a plurality of corresponding locking detents 148 spaced about the interior of the housing 140. Upon insertion of first gimbal housing 138 within second gimbal housing 140, mounting legs 144 slide along locking detents 148 whereby upon clearing the detents 148, locking surfaces 146 of the mounting legs 146 securely engage the locking detents 148 to fix first gimbal housing 138 within second gimbal housing 140 and securing resilient seal member 142 between the components in sandwiched relation. As appreciated, first gimbal housing 138 may be sufficiently resilient to deflect upon insertion to permit mounting legs 144 to clear locking detents 148 and return to their initial position to engage the detents 148.
As mentioned hereinabove, seal member 142 of gimbal mount 104 is secured in interposed relation between first and second gimbal housings 138, 140. Seal member 142 preferably comprises a resilient center material (e.g., polyisoprene or natural rubber) with first and second layers of fabric 150,152 impregnated on the respective proximal and distal surfaces of the resilient center material. Fabric may be of any suitable fabric for example, a SPANDEX material containing about 20% LYCRA and about 80% NYLON available from Milliken. Seal member 142 defines central aperture 154 for sealed reception of a surgical instrument.
In a preferred arrangement, first layer 150 is arranged to extend or overlap into aperture 154. In this manner, the fabric (which is stronger relative to the resilient material) is positioned to engage the surgical instrument upon passage through aperture 154 of seal member 142 thereby protecting the resilient material defining the aperture. This advantageously minimizes the potential of piercing, penetrating or tearing of the resilient material by the instrument. Alternatively, an additional layer of fabric 151 on the proximal surface of seal member 142 may be superposed and arranged to drape within aperture 154. Seal member 142 includes an annular depression 156 (see
Although seal member 142 is disclosed as an impregnated fabric arrangement, it is appreciated that other seal types may be used and still achieve the objectives of the present disclosure. Further,
With reference now to
In a preferred arrangement, gimbal mount 104 may angulate or rotate through an angle inclusive of about 25°, more preferably about 22.5° relative to seal axis “b.” An annular stop (not shown) may further restrict angulation by a couple of degrees of movement to be inclusive of an angle of about 19° relative to axis “b.”
Seal assembly 100 may be associated with, or joined to, cannula assembly 200 in a variety of ways. In a preferred embodiment, seal housing 102 of seal assembly 100 and cannula housing 204 of cannula assembly 200 are adapted to detachably engage each other, e.g., through a bayonet lock or like mechanical means. As previously discussed, proximal and distal housing components 106, 108 may define an upper housing component 109 which is mountable directly to cannula assembly 200. Alternatively, inner housing portion 110 which defines a lower housing component may be directly mounted to cannula assembly 200 independent of the upper housing component 109. Specifically, the lower housing component 110 which houses gimbal mount 104 may be mounted to cannula assembly independent of the remaining housing components. The upper housing may then be mounted to lower housing or cannula assembly 200 as needed. Even further, upper housing component 109 may be mounted to cannula assembly 200 without lower housing component 110. Other means of joining seal assembly 100 to cannula assembly 200 will be readily apparent to one of ordinary skill in the art.
Referring now to
Seal assembly 100 is mounted to cannula assembly 200, which was previously introduced into an insufflated abdominal cavity. An instrument “i” is inserted into seal assembly 100 through passage 116 of inner cylindrical guide wall 112 in seal housing 102. If the axis of the instrument “i” is not perfectly aligned with the axis “a” of cannula assembly 200 or axis “b” of seal assembly 100, then the surgical instrument contacts the inner guide wall 112 and/or the inner surface of seal member 142. Contact with the seal member 142 may cause some deformation of the seal member 142. The instrument “i” slides along the surface of the gimbal mount 104 and/or the seal member 142, to the aperture 154. Aperture 154 stretches to accommodate the instrument diameter, as necessary.
The instrument “i” passes further distally into the cannula housing 204 passing through duckbill valve 220 and cannula sleeve 202 into the body cavity. Once the instrument “i” is disposed within aperture 154, gimbal mount 104 and arcuate surface 118 is overcome, gimbal mount 104 swivels with respect to seal housing 102 as the instrument “i” is manipulated. The gimbal mount 104 is free to swivel relative to housing 102, while allowing seal member 142 to maintain sealing engagement with the instrument “i” passed therethrough, as well as maintaining the seal around the gimbal mount 104. Preferably, the seal member 142 includes resilient material and fabric material, which resists deformation of aperture 154, as well as tearing of seal member 142. Additionally, after gimbal mount 104 has been displaced by surgical instrument “i,” gimbal mount 104 may return to its original unbiased position, when the surgical instrument “i” is removed, via the centering units 410, 610, 710, 810. Centering units 410, 610, 710, 810 act to counterbalance the displacement caused by the insertion of the surgical instrument “i.” In other words, centering units 410, 610, 710, 810 act to center the longitudinal passage or opening 153 of the seal assembly 100 with the central longitudinal axis, “c,” as shown in
Stated differently, the centering units 410, 610, 710, 810 are self-centering elements that push the gimbal mount 104 toward a centered position. The centering units 410, 610, 710, 810 fit within the space between the top of the gimbal mount 104 and the underside of the proximal housing wall. The centering units 410, 610, 710, 810 center the orifice or opening or passage of the seal assembly 100 with the longitudinal axis “c,” as depicted, for example, at
Moreover, cannula housing 204 may include port opening 214 and luer fitting 216 positioned within the port opening 214. Luer fitting 216 is adapted for connection to a supply of insufflation gas and incorporates valve 218 (see
In operation or use, as the instrument “i” is moved up and down axis “e,” the centering units 410, 610, 710, 810 maintain the instrument “i” in its biased position, as desired by the user. The biased position is an off-center positioned with respect to axes “a,” “b” or “c,” as illustrated in
While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of presently disclosed embodiments. Thus the scope of the embodiments should be determined by the appended claims and their legal equivalents, rather than by the examples given.
Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present disclosure. As well, one skilled in the art will appreciate further features and advantages of the present disclosure based on the above-described embodiments. Accordingly, the present disclosure is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.
Smith, Robert C., Kleyman, Gennady
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Apr 07 2013 | SMITH, ROBERT C | Covidien LP | ASSIGNMENT OF ASSIGNORS INTEREST SEE DOCUMENT FOR DETAILS | 030196 | /0947 | |
Apr 11 2013 | Covidien LP | (assignment on the face of the patent) | / |
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